High serum hyaluronic acid and HBV viral load are main prognostic factors of local recurrence after complete radiofrequency ablation of hepatitis B-related small hepatocellular carcinoma.

PURPOSE: The risk factors of local recurrence after complete radiofrequency ablation (RFA) of hepatitis B-related small hepatocellular carcinoma (HCC), ≤3 cm, remains to be clarified. In this study, we evaluated the potential prognostic factors that affect recurrence.

METHODS: A total of 152 consecutive patients with small HCC who had undergone complete RFA were retrospectively studied. The risk factors of local recurrence and their impact on survivals of patients were analyzed.

RESULTS: After a median follow-up of 35 months, intrahepatic recurrence occurred in 67 patients (44.1%). On univariate analysis, HBV DNA, hyaluronic acid, AFP, MELD score, and precollagen III were independent risk factors for recurrence. On multivariate analysis, HBV DNA and hyaluronic acid were independent risk factors for recurrence. The cumulative 1-, 3-, and 5-year disease-free survival rates were 86.8%, 41.2%, and 22.8% in the high viral load group and 96.4%, 65.8%, and 36.7% in the low viral load group, respectively. The difference between the two groups was significant (P=0.003). The cumulative 1-, 3-, and 5-year disease-free survival rates were 87.2%, 42%, and 27.2% in the abnormal hyaluronic acid group and 94.9%, 63.5%, and 33.9% in the normal group, respectively. The difference between the two groups also was significant (P=0.011). Multivariate analysis identified MELD score as the only independent risk factor for overall survival of all patients.

CONCLUSIONS: High serum hyaluronic acid and HBV viral load are main prognostic factors of local recurrence after complete radiofrequency ablation of hepatitis B-related small HCC.